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[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Stage I:  (Usually 4 to 8 months) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Bracket Placement: Brackets are centered mesio distally on the labial or buccal surface with the base of the arch wire slot 4mm from the incisal edge of cusp tips. Only exception is maxillary lateral incisor where 3.5mm from the incisal edge is placed.
Lingual Button: Placed directly opposite to to the areas of engagement of the archwire on the opposite side of the teeth. This is to permit free mesio distal tipping or uprighting of the teeth. If the lingual button is placed incisal or occlusal to the level of base of arch wire the steel ligature would loosen or tighten during mesio distal uprighting.
Buccal Tube: Molar tubes should be parallel to the occlusal surface when viewed from buccal and parallel with a line bisecting the occlusal surface mesiodistally.
Arch wire: Different diameters of wire are available but the most commonly used one is 0.016” wire 0.016” special plus  - Looped arch wire in any case 0.016” special plus - Plain arch wire in extraction cases or in which  1 st  and  2 nd  premolars are extracted 0.018” - Plain arch wire in molar extraction cases Initial Arch wire: The basic shape of the initial archwire depends upon the shape of malocclusion and although it is similar it is seldom identical. The archwire shape is proportional to the width, the form and symmetry of dental arch. There may be localized modifications of archwire in the vertical and horizontal plane and these are called Offset bends.
Offset bends: In Anterior segment Vertical offset - To Intrude or Extrude Horizontal offset - to Expand, contract and rotate In posterior segment Gingival offset - to avoid occlusal distortion and    interference with bicuspids
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Shape of Anterior segment: The anterior curve of the initial arch wire is usually a compromise between the shape of the malocclusion and that of normal occlusion. E.g.: If anterior segment is narrow and protrusive the arch wire is made slightly broader in the cuspid region and flatter opposite to central incisors.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Intermaxillary  Hooks: ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Vertical Loops : ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Horizontal bracket area for severly lingually placed tooth is bent 1mm further gingivally than plane of arch wire to prevent elongation of tooth as it tips labially Contraction Loop in midline with incisor stops to tip crowns of upper centrals Vertical loops bent in case of high frenum attachment
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
Molar anchorage bends: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],The anchorage bend,formerly called the tip back bend is a bend whose vertex faces occlusally
Anchorage bend opposite to molar premolar contact point Labial portion lying in buccal sulci
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
Bayonet bends : Commonly used passively to retain overrotation brought about via previously looped arch. It is inadvisable to use bayonet bends for active correction, because of the tendency for round archwire to rotate within bracket slots causing the bayonet bend to become ineffective or supply movement in wrong plane They should be small and offset section is 5 degrees to the line of main arch.
Use of Lock pins and ligation on arch wires: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Improper method of engaging canine tie
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Placement of Elastics: It is impossible for the arch wire to function properly without the proper elastics. In order to determine the size of the elastics the tension gauge is used. The Class II elastics are engaged around the distal ends of the molar tubes or molar hooks and stretched anteriorly to engage the maxillary Intermaxillary hook mesial to the maxillary cuspid. In Class III elastics are worn from the maxillary molars to the intermaxillary hook mesial to the mandibular cuspid bracket. No horizontal (intramaxillary) elastics are applied during stage I
Class II elastics  pulling 2 to 3 ounce at the beginning Class III elastics Horizontal (intramaxillay) elastic
Check list for stage I : ,[object Object],[object Object]
STAGE MODELS. THE IMPORTANCE OF STAGE MODELS AS TOLD BY DR.A ROCKE,: 1.  TO CHECK THE ARCH CONTOUR AND WIDTH. 2.  TO CHECK THE INCLINATION OF UPPER AND LOWER ANTERIOR TEETH. 3.  SELF-DISCIPLINE TO TO COMPLETE EACH STAGE BEFORE PROCEEDING TO THE NEXT. 4.  TO DETERMINE THE TEETH MOVEMENT. 5.  TO GAIN INSIGHT INTO ANCHORAGE MAINTAINED IN THE TREATMENT. 6.  VISUAL AID FOR PATIENTS AND PARENTS. 7.  VISUAL AID FOR REFERRING DENTISTS THE POSSIBILITY OF ANTERIOR TORQUING..
Stage II:  ( usually 1 to 4 months) ,[object Object],[object Object],[object Object],[object Object]
Arch wire: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
The bypass clamp in position of the bracket in premolar Slight horizontal offsets are formed distal to canines to maintain correct buccolingual position of the premolars and canines-they are the  premolar offsets
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
Inter & Intramaxillary elastics: Lateral Cephalogram is taken and from cephalometric evaluation it is determined whether the anteriors are to be retracted or posteriors are moved for closure of space. The Space – closing elastic ( esp. the maxillary) stretching from the Intermaxillary hook to the molar hook against molar lies against the gingiva and irritates the gingiva, to overcome this elastic is twisted one half turn when it is placed
Wearing of horizontal elastics try to rotate the molars distobuccaly and this should be counteracted by the toe – in bends of the arch wire. If rotation aggravates after giving toe in bends the elastics can be engaged on the lingual hooks. Care should be taken of the second premolar so it doesn’t tip when elastic crosses it occlusally.
Correction of Midline discrepancy: Midline must be determined by reference to the center of face, whether the discrepancy is confined to one arch or in both If  one arch is involved shifts more than 2mm is major; less than 2mm is a minor problem. The application of intramaxillary elastic will complete closure on the side to which midline is shifted; The intramaxillary elastic on the side which closes first can be discontinued Minor discrepancies are self correcting Diagonal elastics for correction of midline in both the arches Correction by movement of individual units or small group after distal tipping of canine
Auxiliaries in stage II: The auxiliaries used are passive mesio distal root uprighting springs on the mandibular canines and the lower anterior braking arches. The function of of these types of auxiliaries is to establish two point contact between teeth and archwire and prevent free tipping movement of the anteriors. Lower braking auxiliary on the four Anteriors
[object Object],[object Object],[object Object],[object Object],[object Object],Changes observed at the end of stage II
Check list for stage II: ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
References: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Beggs satge 1&2

  • 1.
  • 2.
  • 3.
  • 4.
  • 5.
  • 6. Bracket Placement: Brackets are centered mesio distally on the labial or buccal surface with the base of the arch wire slot 4mm from the incisal edge of cusp tips. Only exception is maxillary lateral incisor where 3.5mm from the incisal edge is placed.
  • 7. Lingual Button: Placed directly opposite to to the areas of engagement of the archwire on the opposite side of the teeth. This is to permit free mesio distal tipping or uprighting of the teeth. If the lingual button is placed incisal or occlusal to the level of base of arch wire the steel ligature would loosen or tighten during mesio distal uprighting.
  • 8. Buccal Tube: Molar tubes should be parallel to the occlusal surface when viewed from buccal and parallel with a line bisecting the occlusal surface mesiodistally.
  • 9. Arch wire: Different diameters of wire are available but the most commonly used one is 0.016” wire 0.016” special plus - Looped arch wire in any case 0.016” special plus - Plain arch wire in extraction cases or in which 1 st and 2 nd premolars are extracted 0.018” - Plain arch wire in molar extraction cases Initial Arch wire: The basic shape of the initial archwire depends upon the shape of malocclusion and although it is similar it is seldom identical. The archwire shape is proportional to the width, the form and symmetry of dental arch. There may be localized modifications of archwire in the vertical and horizontal plane and these are called Offset bends.
  • 10. Offset bends: In Anterior segment Vertical offset - To Intrude or Extrude Horizontal offset - to Expand, contract and rotate In posterior segment Gingival offset - to avoid occlusal distortion and interference with bicuspids
  • 11.
  • 12. Shape of Anterior segment: The anterior curve of the initial arch wire is usually a compromise between the shape of the malocclusion and that of normal occlusion. E.g.: If anterior segment is narrow and protrusive the arch wire is made slightly broader in the cuspid region and flatter opposite to central incisors.
  • 13.
  • 14.
  • 15.
  • 16.
  • 17.
  • 18.
  • 19. Horizontal bracket area for severly lingually placed tooth is bent 1mm further gingivally than plane of arch wire to prevent elongation of tooth as it tips labially Contraction Loop in midline with incisor stops to tip crowns of upper centrals Vertical loops bent in case of high frenum attachment
  • 20.
  • 21.
  • 22.
  • 23.
  • 24. Anchorage bend opposite to molar premolar contact point Labial portion lying in buccal sulci
  • 25.
  • 26.
  • 27. Bayonet bends : Commonly used passively to retain overrotation brought about via previously looped arch. It is inadvisable to use bayonet bends for active correction, because of the tendency for round archwire to rotate within bracket slots causing the bayonet bend to become ineffective or supply movement in wrong plane They should be small and offset section is 5 degrees to the line of main arch.
  • 28.
  • 29.
  • 30. Improper method of engaging canine tie
  • 31.
  • 32.
  • 33. Placement of Elastics: It is impossible for the arch wire to function properly without the proper elastics. In order to determine the size of the elastics the tension gauge is used. The Class II elastics are engaged around the distal ends of the molar tubes or molar hooks and stretched anteriorly to engage the maxillary Intermaxillary hook mesial to the maxillary cuspid. In Class III elastics are worn from the maxillary molars to the intermaxillary hook mesial to the mandibular cuspid bracket. No horizontal (intramaxillary) elastics are applied during stage I
  • 34. Class II elastics pulling 2 to 3 ounce at the beginning Class III elastics Horizontal (intramaxillay) elastic
  • 35.
  • 36. STAGE MODELS. THE IMPORTANCE OF STAGE MODELS AS TOLD BY DR.A ROCKE,: 1. TO CHECK THE ARCH CONTOUR AND WIDTH. 2. TO CHECK THE INCLINATION OF UPPER AND LOWER ANTERIOR TEETH. 3. SELF-DISCIPLINE TO TO COMPLETE EACH STAGE BEFORE PROCEEDING TO THE NEXT. 4. TO DETERMINE THE TEETH MOVEMENT. 5. TO GAIN INSIGHT INTO ANCHORAGE MAINTAINED IN THE TREATMENT. 6. VISUAL AID FOR PATIENTS AND PARENTS. 7. VISUAL AID FOR REFERRING DENTISTS THE POSSIBILITY OF ANTERIOR TORQUING..
  • 37.
  • 38.
  • 39.
  • 40. The bypass clamp in position of the bracket in premolar Slight horizontal offsets are formed distal to canines to maintain correct buccolingual position of the premolars and canines-they are the premolar offsets
  • 41.
  • 42.
  • 43. Inter & Intramaxillary elastics: Lateral Cephalogram is taken and from cephalometric evaluation it is determined whether the anteriors are to be retracted or posteriors are moved for closure of space. The Space – closing elastic ( esp. the maxillary) stretching from the Intermaxillary hook to the molar hook against molar lies against the gingiva and irritates the gingiva, to overcome this elastic is twisted one half turn when it is placed
  • 44. Wearing of horizontal elastics try to rotate the molars distobuccaly and this should be counteracted by the toe – in bends of the arch wire. If rotation aggravates after giving toe in bends the elastics can be engaged on the lingual hooks. Care should be taken of the second premolar so it doesn’t tip when elastic crosses it occlusally.
  • 45. Correction of Midline discrepancy: Midline must be determined by reference to the center of face, whether the discrepancy is confined to one arch or in both If one arch is involved shifts more than 2mm is major; less than 2mm is a minor problem. The application of intramaxillary elastic will complete closure on the side to which midline is shifted; The intramaxillary elastic on the side which closes first can be discontinued Minor discrepancies are self correcting Diagonal elastics for correction of midline in both the arches Correction by movement of individual units or small group after distal tipping of canine
  • 46. Auxiliaries in stage II: The auxiliaries used are passive mesio distal root uprighting springs on the mandibular canines and the lower anterior braking arches. The function of of these types of auxiliaries is to establish two point contact between teeth and archwire and prevent free tipping movement of the anteriors. Lower braking auxiliary on the four Anteriors
  • 47.
  • 48.
  • 49.
  • 50.